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Thanks for requesting our latest
assistive technology catalog.

                                  

 

Name  
Title  
  Other Title (please specify)
School/Organization  
Email  
Address  
City   State/Province     Zip/Postal Code  
Phone  



At my school/district, I am responsible for:

A few students
Many students
A large-scale literacy improvement plan or intervention program


My specific initiatives this year are to:




How did you first learn about us?



  Other (please specify)


We appreciate referrals! Who referred you?

Help us thank the person that referred you!

Name  


Best way to contact you:

Best way to contact you:   Email     Phone


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Who in your setting serves students with mild to moderate disabilities?

Me      Other      Job Title  

Who in your setting serves students with autism?

Me      Other      Job Title  

Who in your setting supports students who require AAC devices?

Me      Other      Job Title